Why are members still paying per graft?
You are better off paying a flat fee for the area that is to be transplanted. I did this on my last procedure and it worked out very well.

Who did you do that with. Care to give us all a lesson?

I think the graft estimate for most drs. is an estimate of the size of session.

The name of the dr does not matter, paying by graft is "old school", there is no other cosmetic surgery in which you pay by unit. What you do is agree upon the area to be covered, such as 40 grafts/cm2 you and the dr. sign off on this, and you agree upon the price, this puts the patient back in control.

erldette,

Some physicians charge per graft and others charge a flat fee up to so many grafts, etc. In many but not all cases, a patient ends up paying less per graft than when paying a fee per session size.

Either way, as long as the patient knows and understands the fees, in my opinion, that's all that matters.

Falc

Paying per area can also set you up to get ripped off. my first ht doc did it: i ended up with about 600 grafts and paid $7k. I want to know EXACTLY how many grafts I'm getting. Makes much more sense.

Many dr's sub-cut their grafts to increase their numbers, what i am saying is to get your dr to agree to implant x number of grafts into a given area for a set price.

Falceros, shouldn't all coalition members abide by the same standards?

erldette,

In my opinion, there are benefits and limitations to both pricing strategies.

Remember that "X" is a variable that can't be determined with certainty until the strip is removed and all grafts counted.

Remember also, just as one can argue that some clinics cut smaller grafts, one can also argue that some clinics will throw grafts away. Unfortunately, both have happened.

This is why selecting a quality physician with a proven track record of consistent positive results is imperative, regardless of how they charge.

Falc

Has this happened with coalition members?

I think you should do research on your doc to see who is splitting and who is not. Thats pretty bad!!! If you find the right doc you will not have to worry about being ripped off. I think good docs want there name not tarnished. If I was just coming online and read $$ per graft or Cm2? I would understand the $$$ per graft easyier. Like falc said what if the doc promised you by a flat fee this amount of money and per cm AND THE DOC COULD NOT GET THAT AMOUNT OUT OF YOUR DONOR AREA. I LIKE PER GRAFT AND I WOULD WANT 90 PER CM NOT 40 PER CM

I think selling the procedure per graft is just the easy way to understand what your getting and what your paying for.

On average a “normal” scalp will contain 50% 2 hair Follicular Units 25% 1 hair and 25% 3 or more hairs. Unless there is a special need for additional singles we will not sub divide grafts to increase the numbers. Donor density, skin mobility, size and shape of the head will determine the maximum amount of tissue that can be removed. We normally get somewhere between 97% and 103% of the total grafts that we are shooting for.

We charge per graft and normally give 1-2% of the total number at no charge. We do this because we know that you will never get 100% regrowth (I know some doctors say yes and some say it’s over 100% because of the follicles in the resting phase grow) so we hedge our bets and give some free ones.

If we were to switch over to a flat rate per area, we would have to increase our fees. Lets assume that for a specific area the average number of grafts would be 2000. A white individual with thin shafted light hair might be right at 2000, a white individual with thick shafted hair might be 1900 an African American with very tight curls might only need 1800 to get the same results, etc etc. Each hair type, color, thickness, skin color, epidermis characteristics and other factors all come into play. You can not just say that you can pack 70 or 80 or 90 fu’s per cm2, everyone is different. The doctor determines how many he can safely place based on all aspects of the patient. If we were to charge per area, we would have to charge the maximum that could be done to make sure we covered our costs and made a profit. What if you’re the one who will get the same results with 1750 grafts and get charged for 2000 because of the size of the area you have.

Our doctors use tumescent in the recipient areas (as well as the donor) and the amount of “ballooning” can minimize the total grafts placed or greatly increase it, again until the procedure is under way you never know. The more the skin swells the closer the grafts can be safely placed, the less movement the lower the number.

Every graft made is used, period. Watch out for those charging by the hair not graft gets very expensive.

The other point that i want to make is do not be afraid to bargain with these doctors, you can get at least 1.00/graft lower than the first price quoted, for most people there are more than enough good docs in a geographical are so you are able to shop around.

quote:

there is no other cosmetic surgery in which you pay by unit.

Ever hear of Botox? You pay by the "unit".

"you can get at least 1.00/graft lower than the first price quoted,"

How would you know if you are advocating paying for the session as being the best deal and that is how you just did it with your last surgery? This makes no sense to me.

"for most people there are more than enough good docs in a geographical are so you are able to shop around."

Really? Then why is it that most patients on this board have had to travel by air to get to their clinic of choice?

erldette, did you get a $1 off per graft on your ht? did you come across docs that offereed this? what doc did you go to for yours? it's not clear if you're speaking from experience or if this is conjecture.

In the past I have had price per grafts at $5 per graft. However, I was usually crediting several extra hundred grafts at no charge. Consequently, in my practice, we have moved to a NOT TO EXCEED price for ranges. My goal is to move the most hair with the best quality grafts. There is no incentive to subdivide or get higher graft counts but rather to maximize the result by extracting the most donor hair possible.
OUr structure is as follows:
small sessions: 1500-1800: $7500
Med sessions: 1800-2300: $8500
Large: 2300-3000 $9500
Mega: 3000-4000+: $10500

We are usually at the higheer end of the range in our sessions and we are not sticklers, so if a patient gets 3002 grafts, yes they will fall to the lower price.

I like that you give away extra grafts most doctors do not, this actually lowers the cost per graft. Since you are one of the few Physicians that post, what are your thoughts on paying per session vs paying per graft?

erldette, actually a lot of doctors do give away extra grafts for free. dr.feller got an extra 300 from my strip and did not charge me and i know that's the case with many guys i've read about and talked too through these forums.

You are paying for a top surgeon to do his best work, and your going to ask for a discount? Do you do this with your mechanic, dentist, grocery store, personal physician, etc..

As far as cosmetic surgery costs are concerned you pay a different amount depending on how much is involved. On the following cosmetic procedures:

1: Tummy Tuck - if it is just skin tightening or skin and muscle
2: Nose – Tip only, tip and septum, tip, septum and bone.
3: Liposuction – depends on how many areas
4: Face lifts – Lower – mid – full or brow only
5: Breast Lift – 3 different procedures without implants and 2 with, all different pricing.

All others will have a range depending on the amount of work to be done. More work means more OR time and staff time. About the only cosmetic surgery that has a “fixed cost” is breast augmentation and that will vary on saline or silicone implant.

DISCOUNTS
I don't see a problem with asking if there are any discounts. I know some Drs offer discounts if you make a sizeable down payment when you book a procedure. There are also some Drs who have discounted "standby" pricing if you are willing to be available to come in on short notice when someone else cancels at the last minute. With those in mind I don't see why someone shouldn't ask if there are any discounts or reduced pricing plans.


COST PER AREA VS COST PER GRAFT
I don't think there's really much of a difference in the end result here. First of all there will always be some Drs who will try to cheat you whether they charge per area and spread a small amount of grafts over the entire area or charge per graft and split them all into singles.

So assuming we are dealing with 2 decent Drs, but with differing pricing schemes we get this:

1. Dr A outlines the area to be covered and says it will take about 2500 grafts to cover that area for $4 per graft for a total cost of $10000.

2. Dr B outlines the same area and says he will cover that entire area for $10000. He ends up giving you roughly 2500 grafts because that's how much it takes to properly cover the area.

The end result is the same. I think it's just Dr and patient's preference as to what method of pricing they feel more comfortable with, but I don't think the method itself matters very much.